Care team optimization: Referral management

Care team optimization: Referral management

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By: Terri Embry-Drummond, RN, BSBA, Customer Success, CitusHealth

In this blog series, we’ll travel through the different stages of the patient life cycle and discuss how care teams can optimize the work they do. The first of these is the referral stage. In home health, hospice, palliative care, and home infusion, it’s common for organizations to staff teams who are responsible for capturing and processing referral information in the field.

This role involves managing relationships in hospitals, physician practices, and home-based care agencies, connecting with social workers, discharge planners, or anyone who makes referral decisions, and trying to get referrals for their organization. Once successful, the account manager or liaison reviews charts to qualify patients for referrals, send that information to their office, meet with the patient to do introductions on next steps, and stay in touch with the patient throughout their transition to the home to help ensure comfort and share education about their care plan.

The challenge for many of these home-based care organizations is that the communication methods used to get information from referral sources to initiate and complete a discharge plan are dated and manual. Fax is often used to get demographic and supporting documentation that meet payor criteria to their office, multiple phone calls are needed to follow up to make sure the fax is received, education often happens at the bedside, paperwork must be signed in person, and many texts and emails for everything in between.

Even when referrals happen directly, they arrive via fax and often require several phone calls back and forth to finalize care transitions. How can technology help streamline this referral process? CitusHealth offers digital tools that optimize care teams and provide one single source of truth for each patient case.

With the right technology, home-based care providers can streamline their referral process.

With CitusHealth, new patients are added to the system as they’re onboarded. Patient discussion groups (PDGs) can be initiated right away, allowing anyone with permissions on the care team to start discussions about care, which is saved to the patient record.

The referral liaison, account executive, billing, and admissions—anyone with the correct role—can access these chats and communicate what they need all in one place. It’s the single source of truth communication thread that can begin promptly at onboarding.

PDGs can also be used to get critical information back to referral sources. This includes documentation, care details for payors, benefits, financial responsibilities, etc. Instead of having to make multiple phone calls, it can all be discussed in one secure message thread.

In the end, these conversations can be tagged, recorded on the patient record, and integrated into the organization’s EMR—lessening the need for dual entry and helping to reduce errors. This all-in-one approach to referral management optimizes care teams with seamless communication and digital tools that make care collaboration easier than ever. The information shared supports fast billing, an informed referral source, and most importantly, an informed patient prepared to start service. Schedule a CitusHealth demo today to experience the difference this kind of optimization can make.

Terri Embry-Drummond
Terri Embry-Drummond
RN, BSBA, Vice President of Customer Success, CitusHealth

A registered nurse with a bachelor’s degree in business and marketing, Terri’s career has spanned almost three decades in regional and national home, specialty and long-term care infusion operations, sales, and informatics leadership. Her experience with cutting-edge workflow optimization has allowed her to understand the challenges both customers and their patients face. With CitusHealth, she leads the adoption and retention team helping to bring the voice of customers to the product development roadmap.

Terri has been in leadership, sales, and nursing roles for companies such as BioScrip, Omnicare, and Olsten-Kimberly Quality Care.